Who should determine Medicaid provider reimbursement rates, and how should they compare to other insurance programs or plans? Should the federal government play a stronger role in setting provider rates? Is this an area where it is better to have state variation or national uniformity? Should the federal or state governments be required to ensure that Medicaid reimbursement rates match private insurance reimbursement rates? What might occur if poorer states were required to provide higher reimbursement rates? What is the risk if reimbursement rates are very low?